Many laser surgical systems are known in which a hand-held surgical device is applied by a surgeon to deliver energy to locally heat tissues to such a high temperature that they disintegrate into gaseous and/or vaporized substances. Such a delivery of energy, to effect localized incisions, requires a small tip element shaped and oriented to enable the surgeon to see clearly where the energy is being applied. Although the tip element must be finely formed to allow precise surgery it must be rugged enough for prolonged use, i e., it should not need to be replaced frequently during surgery on a particular patient.
It is inevitable in surgery that blood vessels are occasionally incised, whether the surgeon is applying a scalpel or any other surgical tool. To prevent undesirable bleeding from a cut blood vessel, the surgeon or an assistant typically cauterizes the incised blood vessel as quickly as possible. Such cauterization may require separate tools, but certain versatile laser energy delivering tip elements are also known which enable a user to selectively apply the same tool to effect either incisions or cauterization of incised vessels. One example is disclosed in copending U.S. application Ser. No. 07/812,449 of which this application is a Continuation-In-Part. Pertinent aspects of that application are incorporated herein by reference.
Regardless of how good the local ventilation is in an operating room, a surgeon performing precise incision/cauterization with a surgical tool generating a high temperature locally must contend with the presence of unpleasant odors, smoke and the gaseous and/or vaporized byproducts of the heated tissues every time he or she applies energy. Surgeons and their operating room assistants would experience less stress and be able to function more efficiently if the gaseous and/or vaporized substances produced during such surgery and cauterization were immediately removed from the site where they are produced.
A need, therefore, clearly exists for a rugged high temperature energy delivery tip element which enables a user to remove gaseous and/or vaporized substances immediately upon their production during surgery and cauterization.
Furthermore, even though versatile energy delivery tip elements are known which are useful for both incision making and for cauterization, to simplify the surgeon's task in operating the hand-held laser surgical tool, it is also highly desirable to provide a separately operated cauterization system in which controlled amounts of heat can be selectively delivered by the incision-making tip element itself without the need for separate tools or additional hand-operated actuation elements.
The present invention, as described more fully hereinbelow and as illustrated in the accompanying figures, is intended to meet both of these needs, i.e., to immediately remove gaseous and/or vaporized substances from the surgical site and, with the same tip element, to enable the surgeon to selectively deliver via the same tip element an electrocauterization controlled by a foot-actuated control.